HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions

Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the United States. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. The article concludes that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, the article suggests that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors.     

Neighborhood perceptions and parent outcomes in family based prevention programs for Thai adolescents: the role of program engagement

Due to concerns over Thai adolescent risky behaviors, effective prevention strategies are needed. Determining the role neighborhood context plays in program engagement and outcomes may inform these strategies. This study includes 170 mother-adolescent pairs (M = 13.44, SD = .52) in Bangkok, Thailand in a prevention program for adolescent substance use and sexual risk. Neighborhoods were related to engagement, which was critical to outcomes. Neighborhood disorganization was related to confidence in program effects and program completion. Completion was related to increased ATOD communication. Neighborhood cohesion was related to less program enjoyment, while neighborhood social control was related to more enjoyment. Enjoyment was related to increased ATOD communication and formation and monitoring of alcohol rules. Prevention strategies should focus on neighborhood contexts and enhancing engagement.     

Message and price components of Family Caps: experimental evidence from New Jersey

In this paper, we examine the relative efficacy of two mechanisms--price consideration and the message of social responsibility--in accounting for Family Cap effects on fertility behavior. The Family Cap is a component of welfare reform policy that denies additional cash benefits to children born 10 or more months after a woman entered the welfare rolls. We use data from the New Jersey Family Development Program (FDP) evaluation that employed a classical experimental design. We find that fertility behaviors are influenced by both Family Cap price and message mechanisms but that these effects are conditioned by welfare recipients' time on welfare and race. Black women who have longer stays on welfare are more likely to be influenced by price while women with shorter stays are influenced by both price and the social message. We believe our results have implications not only for future public welfare policy initiatives but for any social policies that attempt to influence behavior directly, through individual rewards and punishments, and indirectly through the activation of social or community pressures.     

Really troubled girls: Gender differences in risky sexual behavior and its correlates in a sample of juvenile offenders

Despite numerous studies on the myriad of psychosocial factors that affect youthful offenders, research on gender differences with respect to risky sexual behavior are limited. Using data on juvenile offenders in a residential facility, we analyzed impact of gender on sexual behavior (N = 227). Girls reported higher likelihood of diagnosis with sexually transmitted diseases, and injecting drug use including heroin and cocaine than boys. Multivariate analysis indicated that number of sexual partners, childhood trauma, and services received from emergency shelter and psychiatric settings were associated with risky sexual behavior. Discouraging, abusive and dysfunctional home environment with little support from parents/caregivers, or teachers, priests/religious leaders appear to dispose youth to a life of risky sex, drugs and delinquency.     

Reducing child poverty by promoting child well-being: Identifying best practices in a time of great need

Child poverty in the United States persists despite a range of social services designed to reduce poverty rates and improve the economic self-sufficiency of families. The economic downturns resulting in job losses and the housing crisis have converged to create a new group of families who were managing to remain out of poverty prior to the recession but are now slipping into poverty, putting additional strain on services. In light of these pressing issues, this article synthesizes the literature examining child poverty to take a long-range view of the relationship between economic strain, system involvement, and impacts on children and the systems attempting to serve these children. The effectiveness of various policy and program efforts aimed at reducing child poverty rates and/or ameliorating the negative effects of living in poverty is reviewed. The article concludes by suggesting a major shift in focus from reducing child poverty as a singular goal to a comprehensive approach to promoting child and family well-being.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

The Canadian Problem Gambling Index: An Evaluation of the Scale and Its Accompanying Profiler Software in a Clinical Setting

Across two studies we assessed the clinical utility of the Canadian Problem Gambling Index (CPGI). In Study 1, the scored items on the CPGI significantly correlated with those of the South Oaks Gambling Screen (SOGS), yet their shared variance was low. Importantly, clinician evaluation of the client’s level of pathology was more strongly associated with that revealed by the CPGI than the SOGS. In terms of utility, clinicians found the non-scored items on the CPGI more useful in treatment than those included with the SOGS. In Study 2, the effectiveness of the CPGI profiler (CPGI-P) software, which graphically depicts problematic gambling-relevant attitudes and behaviours, was assessed. Although clients had difficulties using the CPGI-P interface, they overwhelmingly indicated that the output prompted action to address their gambling. The clinicians were less enthusiastic as they felt the output did not help clients truly understand their gambling problems. Such sentiments were reiterated by the clinicians at a 6 months follow-up. The use of the SOGS and possible adoption of the CPGI (as well as the CPGI-P) in a clinical setting are discussed.     

Where Did All the Pathological Gamblers Go? Gambling Symptomatology and Stage of Change Predict Attrition in Longitudinal Research

Attrition can introduce a systematic bias that can negatively affect validity (Cook and Campbell, Quasi-experimentation: design and analysis issues for field settings. Rand McNally, Chicago, 1979). Current longitudinal research in gambling, however, has generally overlooked the reasons for attrition. The current research examined the relationship between pathological gambling symptomatology, stage of change and attrition. Three hundred and seventy-nine participants were contacted 12 months after initially participating in a study on gambling for a follow-up session. Logistic regression revealed those in the contemplation and preparation stages of change reported higher levels of pathological gambling symptomatology and were more likely to drop out of the study compared to those in the precontemplation stage. As predicted, gambling symptomatology mediated the relationship between stages of change and attrition. The implication for longitudinal research on gambling as well as extant findings that have used this methodological approach is discussed.     

Alcohol Use and Popularity: Social Payoffs From Conforming to Peers' Behavior

Although many economic analyses of adolescents have examined the costs of risky behaviors, few have investigated the gains that young people derive from such actions, particularly in terms of social payoffs for complying with peer behavior. This paper studies the relationship between adolescents' use of alcohol (relative to that of their peers) and popularity at school. We use data from the National Longitudinal Study of Adolescent Health, a rich and nationally representative survey with detailed information on social networks. Our findings suggest that adolescents are socially rewarded for conforming to their peers' alcohol use and penalized (to a lesser degree) for increasing their consumption above that of their peers. Male adolescents are rewarded for keeping up with their peers' drinking and for getting drunk. Female adolescents are rewarded for drinking per se, but not necessarily for keeping up with their peers. The results offer new information on peer influence and have implications for substance abuse interventions at school and in the community.